By Norris Burkes
Posted Apr 2, 2017

The author of Ecclesiastes says there is “a time to every purpose under the heaven; a time to be born, and a time to die.” In my job as health care chaplain, I’ve seen both of these times.

In the 2000s, I comforted the parents of premature babies born in our Neonatal Intensive Care Unit, NICU. These days, I work the other end of life’s journey with hospice patients, most of whom are elderly and struggling for a few more weeks of time.

When I compare my former job in NICU with my current job in hospice, I’m struck by a bit of whiplash as I consider the opposite poles of health care.

In the NICU, I met patients like little Johnny. He lived in a world of wires, IV bottles, and back-lit beds. Doctors, nurses and respiratory therapists constantly squeezed through tangled tubes to deliver highly specialized health care to the tiniest people you’d ever see.

In hospice, our patients remain in their homes, under homemade quilts crafted by our volunteers. Our staff attends them in simple ways with smiles, encouraging words and shared tears. Not much tech, unless you count the electronic tablet we carry for charting.

In hospice, I visit Miss Joni, who like little Johnny marks each breath as a victory. There is a drastic age difference between patients like Johnny and Joni, but they share many similarities.

Both enjoy the gift of life. In the NICU, you can peek at the gift long before you are supposed to peek. In hospice, you must look carefully to find the gift that’s nearly faded beyond recognition.

Both patients are in a race. For Johnny, getting a head start doesn’t mean he will finish the race early — it means his race is longer and full of obstacles. For Miss Joni, it means she sees the finish line come sooner than she wanted.

Both patients struggle to live just one more day. Little Johnny’s parents hope that another day suggests the possibility of a healthy life. For Miss Joni, one more day holds out the tease of another.

Prayers go up for both patients. Prayers for Johnny are offered with fervency and purpose. Miss Joni prays with less certainty, not knowing if she should ask for another day or for a more peaceful departure.

Nurses attend both patients, but Johnny shares his nurse with only one other baby, while Miss Joni shares a nurse and a few aides with 30 other patients.

Machines are a concern to both patients. Machines sustain the hopes of parents while Miss Joni signed papers that declare she refuses to let machines rob her of dignity.

Cost is a concern for both patients. Medical ethicists debate spending so much of the health care dollar to save Johnny. Miss Joni turned to hospice when the bills became impossible.

Both cry. Johnny can’t tell you why he’s crying and Miss Joni can’t stop telling you why she’s crying.

Both have family who think medical staff ought to do more. Both are attended by staff members who think family should be visiting more.

Both require their diapers changed — one by nurses with loving coos and the other by underpaid aides with grimacing faces.

Both are rich — Johnny with potential and Miss Joni with history.

Both face the possibility of death every day. If it comes for Johnny, it will inspire the grief that naturally follows the loss of such potential.

When it comes for Miss Joni, it may likely come with a mixture of grief and relief.

Life will cease for both patients eventually — one at the beginning and one at the end. All of which serves to remind us that, also from Ecclesiastes, “the race is neither to the swift nor the battle to the strong, but time and chance happens to them all.”

— Read Norris’ past columns at Write him at or P.O. Box 247, Elk Grove, Calif., 95759. Twitter @chaplain or call 843-608-9715.